Compliance Update

Historically, the HHS Office of Inspector General (OIG) acted as the sole gatekeeper for excluding bad actors from federal health care programs under Section 1128 of the Social Security Act. That dynamic has fundamentally shifted. HHS Secretary Robert F. Kennedy Jr. officially delegated independent Section 1128 exclusion authority directly to the Centers for Medicare & Medicaid Services...

ABA billable units are not a rounding convention your billing team gets to choose. Florida Medicaid sets the arithmetic in writing, and the rule is that leftover minutes count only when they reach eight. If your agency bills behavior analysis in fifteen-minute increments, you need to know that a documented 52-minute session is three units and not four — because the difference between those two...

Artificial intelligence is quickly becoming a standard part of healthcare operations. From ambient AI documentation tools that generate clinical notes to voice-assisted transcription platforms and automated workflow solutions, healthcare organizations are increasingly adopting technologies designed to improve efficiency and allow providers to spend more time focused on patient care. As these...

Professional Misconduct Allegations are formal claims that your conduct violated professional, ethical, regulatory, or institutional standards, and in healthcare, that accusation alone can threaten your license, privileges, employment, and reputation before any final finding exists. If you are a physician, medical director, or facility administrator, the real issue is not only whether the...

The Trump administration’s rollout of a federal mandate that millions of Americans on Medicaid must work or risk losing health benefits will force states to scrap months of preparation, according to advocates for Medicaid enrollees and consultants advising states. And they say an overhaul — less than seven months before states must start enforcing the requirement — will be costly. Regulations...

FDA’s announcement regarding the launch of AEMS is worth watching. The Adverse Event Monitoring System is intended to consolidate multiple reporting systems across FDA-regulated product categories into a single platform, including medical products, vaccines, devices, tobacco, food, cosmetics, and veterinary products. Legacy systems to be replaced by AEMS now include: FAERS (FDA Adverse Event...